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Provider Credentialing Process

How Do Providers Become Part of Our Network?Thank you for your interest in becoming a participating provider with BlueCross BlueShield of Western New York. We value your business and strive to provide quality service to our Providers and Members.
Initial CredentialingProviders can enroll into our health plan by filling out the Universal Credentialing Application with CAQH, the Council for Affordable Quality Healthcare.
How it Works:Follow this link to access theUniversal Provider DataSource

Under Providers, click: 'Go to the Universal Provider Datasource' and login.

If you are a physician, nurse practitioner, CRNA or physician assistant practicing within the specialty of Hospitalist, Anesthesia, Emergency Medicine or Pathology and your medical practice is based out of an acute care hospital, you are eligible to enroll as a hospital-based provider using the hospital-based provider registration.

The CAQH Universal Credentialing Application is our data source for recredentialing. As such, it is important that you keep your information on CAQH current. Update your CAQH application regularly with license(s), malpractice, demographic information, disclosure questions and attest to the accuracy of the information in the application.

As part of your credentialing or recredentialing, BlueCross BlueShield of Western New York is requesting that you join the Association for Medical Ethics (AME), which we are partnering with.Join now.

The influence of pharmaceutical and medical device manufacturers is generally beneficial to our patients’ health, but sometimes the goal of corporate profits impacts their care negatively. Most of the time doctors and patients are completely unaware of these subtle and pervasive influences that can be harmful. Increasing this awareness to avoid patient injury and improve care is the purpose of our partnership with AME.

We are requesting that our physicians join AME as a way to demonstrate to our members their support of the appropriate and informed use of evidence-based medicine and the need to ensure transparency in industry supported research and practice. Patients and doctors are affected immensely in almost all daily medical decisions by industries’ opaque financial influence, often to the severe detriment of patient care.

Our partnership with AME will include CME programming on these topics and health/wellness interventions. You can take the CME course at: www.courses.ethicaldoctor.org